- Associated Press - Monday, May 16, 2016

Des Moines Register. May 12, 2016

Medical errors are a deadly epidemic.

Cancer and heart disease are the leading causes of death in the United States. People diagnosed with these illnesses turn to the medical community for help. But doing that presents yet another risk to their lives. Medical errors in hospitals and health facilities are now the third leading cause of death in this country, according to a new study. Mistakes made in the places we rely on for care claim 251,000 lives annually. That’s more than respiratory disease, accidents and strokes. It’s more than Alzheimer’s, diabetes and pneumonia combined.

“It boils down to people dying from the care that they receive rather than the disease for which they are seeking care,” said Martin Makary, a professor at the Johns Hopkins University School of Medicine who led the research.

The findings are consistent with a February report about medical errors in Iowa from the Clive-based Heartland Health Research Institute. President David P. Lind, also relying on the best available data and existing studies, calculated 2,444 Iowa patients are fatally injured in hospitals each year. In addition to reporting on Lind’s findings, the Register editorial board found gruesome examples of medical errors across the state. No state fines were imposed as a result of any of those violations.

Yet health facilities may not acknowledge, let alone be held responsible for, such errors. Reporting is frequently voluntary and measuring any progress is virtually impossible.

This country needs a mandatory, comprehensive method to document and make public all medical mistakes that injure and kill patients. Death certificates should include a field asking whether a preventable complication stemming from the patient’s care contributed to the death. Meaningful reporting is the first step to improving care and outcomes.

Patients have a right to information about what is happening in hospitals. When health facilities know the public is watching, they have an incentive to take action to avoid medical errors in the first place. These institutions receive billions of dollars annually from insurers, including publicly funded Medicare and Medicaid, with too little accountability for costly, preventable mistakes.

Death from cancer may be unavoidable, but a nurse administering the wrong drug to a patient is avoidable. Health facilities should employ more practices to prevent deadly errors, including air bubbles in chest tubes, oxygen lines carrying the wrong gas, surgical tools left in patients, the wrong artery being cleared and the spread of bacteria that later kills patients.

While the number of people equivalent to the population of Des Moines die each year in this country due to medical errors, thousands more survive preventable mistakes. They go on to live with damage created by botched biopsies, oxygen deprivation and medication mix-ups. Lind’s research indicates 85,000 Iowans are “silently” harmed each year by avoidable errors. They lived. They are the lucky ones.___

Iowa City Press-Citizen. May 14, 2016

Action required on affordable housing issue.

The situation at Rose Oaks has thrown the need for better and more readily available affordable housing into sharp relief for the residents of Johnson County.

Tenants, after demanding a resolution to the abrupt renovations that left them with little time to relocate, received an extended grace period after protesting and striking a deal with property managers, and Iowa City has given funds to Shelter House to aid in the transition for residents seeking new living arrangements. This measure, taken under pressure from tenants and concerned citizens, was the right course of action to assist people in this particular situation. But the long-term issue - that of the availability of low-income housing - remains unsolved, and more incidents like what has taken place at Rose Oaks are in the cards if a permanent fix can’t be found.

The most recent Iowa City Council elections were, in part, a referendum on a perceived lack of action from municipal government to benefit the least fortunate in the community. The slate of candidates elected promised to make good on the public’s trust by spearheading policy moves to create a more equitable environment in Iowa City, where even low wage earners could expect a certain standard of living, including housing within a reasonable distance from work and at a price that wouldn’t empty their already slim coffers. Last year’s vote appeared to be an overwhelming show of support for this philosophy, and leadership on issues like these is where one’s commitment to these ideals can be shown. Doing right by Rose Oaks tenants is one thing. Getting to work figuring out how this doesn’t happen again is another.

While council members naturally have quite a lot on their plates on any given day or week, it is our hope city government sets an example to other municipalities and county authorities by taking this issue head-on, making it a priority in the coming months. Developers will need a say in this, as well. Perhaps one way of ensuring new housing developments have adequate space for low-income tenants would be requiring such a partitioning as a condition of distributing Tax-Increment Financing deals to those wishing to build within city limits, or an institution of rent control. These are but a couple of examples of measures that could be taken to ameliorate this shortage, and surely others exist that could work even better, perhaps as an “omnibus” initiative containing multiple new policy directions.

We do not purport to have the “magic bullet” solution to this problem, and neither do city and local governments. But it’s up to them to get to work determining the best step to take in light of the continued struggles low-income residents face when trying to find affordable housing. Commuting costs money, and the more wages stay in the pockets of employees who work and live in Iowa City, the more money gets recirculated in the economy. Guaranteeing a choice in housing for everyone who lives in the area - and not just the wealthy - isn’t just the right thing to do. It’s the sensible thing to do.___

Dubuque Telegraph Herald. May 13, 2016

Taxpayer-funded mail standards merit scrutiny.

For a congressman crusading to get government spending under control, Rod Blum doesn’t appreciate questions about his spending.

As has been reported here and elsewhere, Blum, a freshman Republican from Dubuque, spends more of his congressional allowance on mass mailings, advertisements and automated phone calls than any of his colleagues. He says he’s proud of the ranking and that it reflects his commitment to stay in communication with his constituents in Northeast Iowa.

But questioning the content of the mailings, as we started to do the other day, is, in his view, “sophomoric,” not newsworthy and shows us to be “lapdogs” for the Democrats. It’s a non-issue, in his view.

Our raising the topic sparked such a litany of complaints about the TH - other media outlets came in for some lumps, too - that we needed to remind ourselves that, yes, the TH did endorse him for election in 2014. (Blum told us he couldn’t recall. He can check his own Facebook page to verify that it’s true.)

The audio from that 13-minute segment of our hour-plus meeting, which otherwise was pretty darn cordial and productive, accompanies this editorial at THonline.com/opinion.

Actually, his criticism notwithstanding, we don’t particularly care what Blum spends on taxpayer-funded mailings and other communication. To be No. 1 in Congress in that category is noteworthy and newsworthy, but it’s his decision how to spend his budget. As far as we’re concerned, he could mail out something weekly or daily if his budget allows it. (Blum elects to spend more on mailings and less on staff than his peers in D.C., and, to his credit, he still returned more than $100,000 of his unspent annual budget to the Treasury.)

What we do care about is the content of the mailings, which are barely distinguishable from the political campaign literature that fills our mailboxes every election cycle. (We’re not alone: Editorials in The Des Moines Register and the Cedar Rapids Gazette, as well as a news report this week on KCRG-TV, have made the same point.)

For example, the cover of a recent mailing carried a large American flag, Blum’s photo and the message: “Congressman Rod Blum - Unwavering Leadership - Keeping America Safe.” As a taxpayer, you helped pay for that.

While in our view that sort of cover verbiage crosses the line from informational to political - the inside pages push the limits but are pretty typical for incumbents - the bigger concern is a congressional system that permits it. Blum’s mailings pass muster with the Commission on Congressional Mailing Standards, where a representative of the Democrats and a representative of the Republicans sign off on each release. It makes us wonder whether there exists a quid pro quo - “We won’t veto your incumbent’s mailing if you won’t veto ours.”

While we think Blum should dial back the self-promotional tone of his taxpayer-funded mailings, and not become so agitated when a discussion of congressional spending includes his own, we think the more important questions center around a system that permits such promotional and political messages on the taxpayers’ tab.___

Quad-City Times. May 10, 2016

Jurists can learn from Iowa’s Supreme Court.

There’s no greater threat to the U.S. justice system than partisan tantrums from those hell-bent on getting their own way. Iowa’s Supreme Court justices are offering a plan to beat back the political assault.

The threat isn’t limited to the spat over President Obama’s nominee to the U.S. Supreme Court. It’s not isolated to calls from the likes of Sen. Ted Cruz, R-Texas, for “term limits” on Supreme Court justices. It’s being fought in legislatures throughout the country, particularly in red states where anger persists over rulings that countered the movement’s various unconstitutional platforms.

The Kansas Senate last month approved legislation that would permit the impeachment of state Supreme Court justices. Lawmakers there threatened to withhold the court’s funding. Both proposals came after Kansas’ high court blocked anti-abortion laws championed by Gov. Sam Brownback and struck down attempts to defund primary education.

Demagoguery for political gain undermines every tenet of the justice system.

Iowa’s judge selection process for vacant Supreme Court seats is better than most. In Illinois, justices tour the campaign trail, begging monied interests for cash. It’s a system that introduces potential conflicts of interest in spades.

In Iowa, a nominating panel drafts a short-list of potential nominees, from which the governor selects. But, as with any human endeavor, any step along the way carries a tinge of partisanship. Justices are, after all, reviewed by a panel of their peers, all of whom have agendas. They are selected by a governor, a job built for political animals looking for specific legal perspectives.

Just ask the three justices sacked in 2010’s retention vote, months after Iowa’s highest judicial panel overturned the state’s constitutional ban on gay marriage. Three more members of the court that issued the unanimous ruling, including that decision’s author Chief Justice Mark Cady, face retention in November. While the most hardcore defenders of so-called “traditional marriage” are lining up to again take on any justice that disagreed with them, the unprecedented rate of social evolution on gay marriage will hopefully prove 2010 to be a one-time blip.

The view - often fostered by politicians looking to whip up their base - that justices are part of the political process is what keeps Cady, widely considered a conservative jurist, up at night, he told the Quad-City Times editorial board on Wednesday.

“We’ve struggled with it at times,” Cady said, when referring to the politicization what’s intended to be an impartial, law-based process. “We struggled with it in 2010.”

In response, the Branstad appointee has taken some of the court’s lesser cases on the road, holding arguments in schools throughout the state. Cady’s justices speak at schools. They livestream their cases on the Internet. They meet with editorial boards. They talk freely with journalists. They offer lofty ethical arguments about the independence of the judicial branch. Cady has even lobbied for U.S. Supreme Court justices to accept modern reality and permit cameras in that courtroom.

Cady lobbied Kansas Chief Justice Lawton Nuss to undertake a similar campaign to engage the public about the importance of apolitical impartiality, he said. Many on Nuss’ court rebuffed the idea. So Cady engaged them directly via Skype, he said.

“They’ve had some difficulty (in Kansas),” Cady said. “They’re under attack.”

Cady is correct. Jurists must let go of outdated pageantry and engage the public if they intend to stem the partisan threat.

No human endeavor is apolitical. True objectivity is beyond humanity. But the American court system hinges on an ethos that strives for impartiality. And that mantra is, once again, threatened by those who can’t see beyond their own politics.

It’s up to the justices themselves to make a stand for ethics and reason.

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